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. 2005 Sep;62(9):616–622. doi: 10.1136/oem.2004.018291

Mould/dampness exposure at home is associated with respiratory disorders in Italian children and adolescents: the SIDRIA-2 Study

M Simoni 1, E Lombardi 1, G Berti 1, F Rusconi 1, S La Grutta 1, S Piffer 1, M Petronio 1, C Galassi 1, F Forastiere 1, G Viegi 1, S the 1
PMCID: PMC1741087  PMID: 16109818

Abstract

Aims: To report on the relation between home mould and/or dampness exposure and respiratory disorders in a large sample of children and adolescents in Italy, accounting for age at time of exposure.

Methods: 20 016 children (mean age 7 years) and 13 266 adolescents (mean age 13 years) completed questionnaires on indoor exposures and respiratory symptoms/diseases. Statistical analyses were adjusted for sex, age, questionnaire's compiler, area of residence, season of interview, parental educational status, family history of asthma, rhinitis, eczema, chronic obstructive pulmonary disease, presence of gas water heaters, passive smoking, pets, and active smoking (only for adolescents). Population attributable risk % (PAR) was also computed.

Results: Asthma was more strongly related to only early than to only current exposure, both in children (OR 1.80, 95% CI 1.41 to 2.30) and adolescents (OR 1.89, 95% CI 1.38 to 2.59). The same result was found for rhino-conjunctivitis (OR 1.46, 95% CI 1.17 to 1.82), in children, and for wheeze among adolescents (OR 1.56, 95% CI 1.15 to 2.11). In children, wheeze (OR 1.98, 95% CI 1.47 to 2.66) and eczema (OR 1.44, 95% CI 1.09 to 1.91) were more strongly related to mould/dampness when exposed both early and currently; the same occurred in adolescents for rhino-conjunctivitis (1.78, 95% CI 1.30 to 2.45). Although persistent cough/phlegm was significantly related to mould/dampness exposure in children, regardless of exposure timing, no significant association between mould/dampness exposure and eczema or cough/phlegm was found among adolescents. PAR estimates were higher for only early than only current exposures. Avoiding early only exposure would abate wheeze by 6%, asthma or cough/phlegm by 7%, rhino-conjunctivitis in children by 4%, and in adolescents, asthma by 6%, and wheeze by 4%.

Conclusions: Respiratory disorders such as wheeze and asthma can often be explained by exposure to home mould/dampness, especially early in life. The association seems more evident in children than in adolescents. These findings may suggest the need for environmental prevention strategies.

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Selected References

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  1. Agabiti N., Mallone S., Forastiere F., Corbo G. M., Ferro S., Renzoni E., Sestini P., Rusconi F., Ciccone G., Viegi G. The impact of parental smoking on asthma and wheezing. SIDRIA Collaborative Group. Studi Italiani sui Disturbi Respiratori nell'Infanzia e l'Ambiente. Epidemiology. 1999 Nov;10(6):692–698. doi: 10.1097/00001648-199911000-00005. [DOI] [PubMed] [Google Scholar]
  2. Asher M. I., Keil U., Anderson H. R., Beasley R., Crane J., Martinez F., Mitchell E. A., Pearce N., Sibbald B., Stewart A. W. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995 Mar;8(3):483–491. doi: 10.1183/09031936.95.08030483. [DOI] [PubMed] [Google Scholar]
  3. Belanger Kathleen, Beckett William, Triche Elizabeth, Bracken Michael B., Holford Theodore, Ren Ping, McSharry Jean-ellen, Gold Diane R., Platts-Mills Thomas A. E., Leaderer Brian P. Symptoms of wheeze and persistent cough in the first year of life: associations with indoor allergens, air contaminants, and maternal history of asthma. Am J Epidemiol. 2003 Aug 1;158(3):195–202. doi: 10.1093/aje/kwg148. [DOI] [PubMed] [Google Scholar]
  4. Billings C. G., Howard P. Damp housing and asthma. Monaldi Arch Chest Dis. 1998 Feb;53(1):43–49. [PubMed] [Google Scholar]
  5. Brunekreef B., Dockery D. W., Speizer F. E., Ware J. H., Spengler J. D., Ferris B. G. Home dampness and respiratory morbidity in children. Am Rev Respir Dis. 1989 Nov;140(5):1363–1367. doi: 10.1164/ajrccm/140.5.1363. [DOI] [PubMed] [Google Scholar]
  6. Cuijpers C. E., Swaen G. M., Wesseling G., Sturmans F., Wouters E. F. Adverse effects of the indoor environment on respiratory health in primary school children. Environ Res. 1995 Jan;68(1):11–23. doi: 10.1006/enrs.1995.1003. [DOI] [PubMed] [Google Scholar]
  7. Dales R. E., Miller D., McMullen E. Indoor air quality and health: validity and determinants of reported home dampness and moulds. Int J Epidemiol. 1997 Feb;26(1):120–125. doi: 10.1093/ije/26.1.120. [DOI] [PubMed] [Google Scholar]
  8. Dales R. E., Zwanenburg H., Burnett R., Franklin C. A. Respiratory health effects of home dampness and molds among Canadian children. Am J Epidemiol. 1991 Jul 15;134(2):196–203. doi: 10.1093/oxfordjournals.aje.a116072. [DOI] [PubMed] [Google Scholar]
  9. Dekker C., Dales R., Bartlett S., Brunekreef B., Zwanenburg H. Childhood asthma and the indoor environment. Chest. 1991 Oct;100(4):922–926. doi: 10.1378/chest.100.4.922. [DOI] [PubMed] [Google Scholar]
  10. Douwes Jeroen, Pearce Neil. Invited commentary: is indoor mold exposure a risk factor for asthma? Am J Epidemiol. 2003 Aug 1;158(3):203–206. doi: 10.1093/aje/kwg149. [DOI] [PubMed] [Google Scholar]
  11. Engvall K., Norrby C., Norbäck D. Sick building syndrome in relation to building dampness in multi-family residential buildings in Stockholm. Int Arch Occup Environ Health. 2001 May;74(4):270–278. doi: 10.1007/s004200000218. [DOI] [PubMed] [Google Scholar]
  12. Forsberg B., Pekkanen J., Clench-Aas J., Mårtensson M. B., Stjernberg N., Bartonova A., Timonen K. L., Skerfving S. Childhood asthma in four regions in Scandinavia: risk factors and avoidance effects. Int J Epidemiol. 1997 Jun;26(3):610–619. doi: 10.1093/ije/26.3.610. [DOI] [PubMed] [Google Scholar]
  13. Hyndman S. J. Housing dampness and health amongst British Bengalis in east London. Soc Sci Med. 1990;30(1):131–141. doi: 10.1016/0277-9536(90)90336-q. [DOI] [PubMed] [Google Scholar]
  14. Jaakkola J. J., Jaakkola N., Ruotsalainen R. Home dampness and molds as determinants of respiratory symptoms and asthma in pre-school children. J Expo Anal Environ Epidemiol. 1993;3 (Suppl 1):129–142. [PubMed] [Google Scholar]
  15. Jacob Beate, Ritz Beate, Gehring Ulrike, Koch Andrea, Bischof Wolfgang, Wichmann H. E., Heinrich Joachim. Indoor exposure to molds and allergic sensitization. Environ Health Perspect. 2002 Jul;110(7):647–653. doi: 10.1289/ehp.02110647. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Jedrychowski W., Flak E. Separate and combined effects of the outdoor and indoor air quality on chronic respiratory symptoms adjusted for allergy among preadolescent children. Int J Occup Med Environ Health. 1998;11(1):19–35. [PubMed] [Google Scholar]
  17. Kilpeläinen M., Terho E. O., Helenius H., Koskenvuo M. Home dampness, current allergic diseases, and respiratory infections among young adults. Thorax. 2001 Jun;56(6):462–467. doi: 10.1136/thorax.56.6.462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Koch Anders, Mølbak Kåre, Homøe Preben, Sørensen Per, Hjuler Thomas, Olesen Mette Ehmer, Pejl June, Pedersen Freddy Karup, Olsen Ove Rosing, Melbye Mads. Risk factors for acute respiratory tract infections in young Greenlandic children. Am J Epidemiol. 2003 Aug 15;158(4):374–384. doi: 10.1093/aje/kwg143. [DOI] [PubMed] [Google Scholar]
  19. Lanphear B. P., Aligne C. A., Auinger P., Weitzman M., Byrd R. S. Residential exposures associated with asthma in US children. Pediatrics. 2001 Mar;107(3):505–511. doi: 10.1542/peds.107.3.505. [DOI] [PubMed] [Google Scholar]
  20. Lau Susanne, Nickel Renate, Niggemann Bodo, Grüber Christoph, Sommerfeld Christine, Illi Sabina, Kulig Michael, Forster Johannes, Wahn Ulrich, Groeger Marketa. The development of childhood asthma: lessons from the German Multicentre Allergy Study (MAS). Paediatr Respir Rev. 2002 Sep;3(3):265–272. doi: 10.1016/s1526-0542(02)00189-6. [DOI] [PubMed] [Google Scholar]
  21. Lee Yung-Ling, Lin Ying-Chu, Hsiue Tzuen-Ren, Hwang Bing-Fang, Guo Yueliang Leon. Indoor and outdoor environmental exposures, parental atopy, and physician-diagnosed asthma in Taiwanese schoolchildren. Pediatrics. 2003 Nov;112(5):e389–e389. doi: 10.1542/peds.112.5.e389. [DOI] [PubMed] [Google Scholar]
  22. Li C. S., Hsu L. Y. Home dampness and childhood respiratory symptoms in a subtropical climate. Arch Environ Health. 1996 Jan-Feb;51(1):42–46. doi: 10.1080/00039896.1996.9935992. [DOI] [PubMed] [Google Scholar]
  23. McConnell Rob, Berhane Kiros, Gilliland Frank, Islam Talat, Gauderman W. James, London Stephanie J., Avol Edward, Rappaport Edward B., Margolis Helene G., Peters John M. Indoor risk factors for asthma in a prospective study of adolescents. Epidemiology. 2002 May;13(3):288–295. doi: 10.1097/00001648-200205000-00009. [DOI] [PubMed] [Google Scholar]
  24. McNally N. J., Williams H. C., Phillips D. R. Atopic eczema and the home environment. Br J Dermatol. 2001 Nov;145(5):730–736. doi: 10.1046/j.1365-2133.2001.04474.x. [DOI] [PubMed] [Google Scholar]
  25. Norbäck D., Björnsson E., Janson C., Palmgren U., Boman G. Current asthma and biochemical signs of inflammation in relation to building dampness in dwellings. Int J Tuberc Lung Dis. 1999 May;3(5):368–376. [PubMed] [Google Scholar]
  26. Platt S. D., Martin C. J., Hunt S. M., Lewis C. W. Damp housing, mould growth, and symptomatic health state. BMJ. 1989 Jun 24;298(6689):1673–1678. doi: 10.1136/bmj.298.6689.1673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Renzoni E., Forastiere F., Biggeri A., Viegi G., Bisanti L., Chellini E., Ciccone G., Corbo G., Galassi C., Rusconi F. Differences in parental- and self-report of asthma, rhinitis and eczema among Italian adolescents. SIDRIA collaborative group. Studi Italiani sui Disordini Respiratori dell' Infanzia e l'Ambiente. Eur Respir J. 1999 Sep;14(3):597–604. doi: 10.1034/j.1399-3003.1999.14c19.x. [DOI] [PubMed] [Google Scholar]
  28. Sotir Mark, Yeatts Karin, Shy Carl. Presence of asthma risk factors and environmental exposures related to upper respiratory infection-triggered wheezing in middle school-age children. Environ Health Perspect. 2003 Apr;111(4):657–662. doi: 10.1289/ehp.5824. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Strachan D. P. Damp housing and childhood asthma: validation of reporting of symptoms. BMJ. 1988 Nov 12;297(6658):1223–1226. doi: 10.1136/bmj.297.6658.1223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Verhoeff A. P., van Strien R. T., van Wijnen J. H., Brunekreef B. Damp housing and childhood respiratory symptoms: the role of sensitization to dust mites and molds. Am J Epidemiol. 1995 Jan 15;141(2):103–110. doi: 10.1093/oxfordjournals.aje.a117398. [DOI] [PubMed] [Google Scholar]
  31. Waegemaekers M., Van Wageningen N., Brunekreef B., Boleij J. S. Respiratory symptoms in damp homes. A pilot study. Allergy. 1989 Apr;44(3):192–198. doi: 10.1111/j.1398-9995.1989.tb02261.x. [DOI] [PubMed] [Google Scholar]
  32. Williamson I. J., Martin C. J., McGill G., Monie R. D., Fennerty A. G. Damp housing and asthma: a case-control study. Thorax. 1997 Mar;52(3):229–234. doi: 10.1136/thx.52.3.229. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Yang C. Y., Chiu J. F., Chiu H. F., Kao W. Y. Damp housing conditions and respiratory symptoms in primary school children. Pediatr Pulmonol. 1997 Aug;24(2):73–77. doi: 10.1002/(sici)1099-0496(199708)24:2<73::aid-ppul1>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  34. Zacharasiewicz A., Zidek T., Haidinger G., Waldhör T., Vutuc C., Zacharasiewicz A., Goetz M., Pearce N. Symptoms suggestive of atopic rhinitis in children aged 6-9 years and the indoor environment. Allergy. 2000 Oct;55(10):945–950. doi: 10.1034/j.1398-9995.2000.00575.x. [DOI] [PubMed] [Google Scholar]
  35. Zock Jan-Paul, Jarvis Deborah, Luczynska Christina, Sunyer Jordi, Burney Peter, European Community Respiratory Health Survey Housing characteristics, reported mold exposure, and asthma in the European Community Respiratory Health Survey. J Allergy Clin Immunol. 2002 Aug;110(2):285–292. doi: 10.1067/mai.2002.126383. [DOI] [PubMed] [Google Scholar]

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